Long-Term Outcomes Following Inguinal Hernia Repair With Mesh Performed by Medical Doctors and Surgeons in Ghana.

Objective: To assess long-term outcomes following inguinal hernia repair with mesh performed by medical doctors and surgeons in Ghana.

Background: Task sharing of surgical care with nonsurgeons can increase access to essential surgery. Long-term safety and outcomes of task sharing are not well-described for hernia repair.

Standardised Competency-Based Training of Medical Doctors and Associate Clinicians in Inguinal Repair with Mesh in Sierra Leone.

Introduction: In low-income settings, there is a high unmet need for hernia surgery, and most procedures are performed with tissue repair techniques. In preparation for a randomized clinical trial, medical doctors and associate clinicians received a short-course competency-based training on inguinal hernia repair with mesh under local anaesthesia. The aim of this study was to evaluate feasibility, safety and effectiveness of the training.

Economic evaluation of expanding inguinal hernia repair among adult males in Ghana.

An unmet need for inguinal hernia repair is significant in Ghana where the number of specialist general surgeons is extremely limited. While surgical task sharing with medical doctors without formal specialist training in surgery has been adopted for inguinal hernia repair in Ghana, no prior research has been conducted on the long-term costs and health outcomes associated with expanding operations to repair all inguinal hernias among adult males in Ghana. The study aimed to estimate cost-effectiveness of elective open mesh repair performed by medical doctors and surgeons for adult males with primary inguinal hernia compared to no treatment in Ghana and to project costs and health gains associated with expanding operation services through task sharing between medical doctors and surgeons.

Cost-Effectiveness Analysis of Inguinal Hernia Repair With Mesh Performed by Surgeons and Medical Doctors in Ghana.

Objectives: Task-sharing is the pragmatic sharing of tasks between providers with different levels of training. To our knowledge, no study has examined the cost-effectiveness of surgical task-sharing of hernia repair in a low-resource setting. This study has aimed to evaluate and compare the cost-effectiveness of mesh repair performed by Ghanaian surgeons and medical doctors (MDs) following a standardized training program.

Increasing the use of continuing professional development courses to strengthen trauma care in Ghana.

Unlabelled: Injury is a major cause of death and disability in Ghana. Strengthening care of the injured is essential to reduce this burden. Trauma continuing professional development (CPD) courses are an important component of strengthening trauma care.

Outcomes After Elective Inguinal Hernia Repair Performed by Associate Clinicians vs Medical Doctors in Sierra Leone: A Randomized Clinical Trial.

Importance: Task sharing of surgical duties with medical doctors (MDs) without formal surgical training and associate clinicians (ACs; health care workers corresponding to an educational level between that of a nurse and an MD) is practiced to provide surgical services to people in low-resource settings. The safety and effectiveness of this has not been fully evaluated through a randomized clinical trial.

Objective: To determine whether task sharing with MDs and ACs is safe and effective in mesh hernia repair in Sierra Leone.

Outcomes After Inguinal Hernia Repair With Mesh Performed by Medical Doctors and Surgeons in Ghana.

Importance: Inguinal hernia is the most common general surgical condition in the world. Although task sharing of surgical care with nonsurgeons represents one method to increase access to essential surgery, the safety and outcomes of this strategy are not well described for hernia repair.

Objective: To compare outcomes after inguinal hernia repair with mesh performed by medical doctors and surgeons in Ghana.

Breast Cancer and African Ancestry: Lessons Learned at the 10-Year Anniversary of the Ghana-Michigan Research Partnership and International Breast Registry.

Women with African ancestry in western, sub-Saharan Africa and in the United States represent a population subset facing an increased risk of being diagnosed with biologically aggressive phenotypes of breast cancer that are negative for the estrogen receptor, the progesterone receptor, and the / marker. These tumors are commonly referred to as triple-negative breast cancer. Disparities in breast cancer incidence and outcome related to racial or ethnic identity motivated the establishment of the International Breast Registry, on the basis of partnerships between the Komfo Anokye Teaching Hospital in Kumasi, Ghana, the University of Michigan Comprehensive Cancer Center in Ann Arbor, Michigan, and the Henry Ford Health System in Detroit, Michigan.

Extra gonadal sclerosing stromal tumour in the transverse mesocolon.

Sclerosing stromal tumour (SST) is a rare benign sex cord stromal tumour of the ovary. We report a case of sclerosing stromal tumour of the mesentery in a 32-year-old Para one who presented with intra abdominal mass, menstrual irregularity and secondary infertility. Histopathology and immunohistochemistry of the completely excised tumour was consistent with sclerosing stromal tumour, immunoreactive only to vimentin.

Prevalence of Inguinal Hernia in Adult Men in the Ashanti Region of Ghana.

Background: Inguinal hernia is thought to be common in rural Ghana, though no recent data exist on hernia prevalence in the country. This information is needed to guide policy and increase access to safe hernia repair in Ghana and other low-resource settings.

Methods: Adult men randomly selected from the Barekese sub-district of Ashanti Region, Ghana were examined by surgeons for the presence of inguinal hernia.

Perforated peptic ulcer.

Perforated peptic ulcer is a common emergency condition worldwide, with associated mortality rates of up to 30%. A scarcity of high-quality studies about the condition limits the knowledge base for clinical decision making, but a few published randomised trials are available. Although Helicobacter pylori and use of non-steroidal anti-inflammatory drugs are common causes, demographic differences in age, sex, perforation location, and underlying causes exist between countries, and mortality rates also vary.

Characterizing Breast Cancer in a Population with Increased Prevalence of Triple-Negative Breast Cancer: Androgen Receptor and ALDH1 Expression in Ghanaian Women.

Background: The androgen receptor (AR) is a commonly-expressed hormone receptor in breast cancer and may be a marker of response to targeted anti-androgen therapy, a particularly attractive option for triple-negative breast cancer (TNBC). Gene expression studies suggest that ARs may distinguish a luminal/AR TNBC subtype from stem cell-like subtypes. TNBC frequency is two to three times higher in African American and African breast cancers compared with White American and European breast cancers, yet little is known regarding TNBC subtypes in high-frequency African-ancestry populations.

Strangulated inguinal hernia in adult males in Kumasi.

Background: The complications of untreated inguinal hernias are common surgical emergencies in adult Ghanaian men.

Objective: To describe the epidemiology of strangulated inguinal hernia in adult males in Kumasi.

Method: From the hospital records the age and sex of all male adult patients treated for strangulated inguinal hernia were recorded at the Komfo Anokye Teaching Hospital(KATH), the University Hospital (UH), the Seventh Day Adventist Hospital (SDAH) and the Kumasi South Hospital (KSH) for the period January 2007 to December 2011 inclusive.

Quality of referrals for elective surgery at a tertiary care hospital in a developing country: an opportunity for improving timely access to and cost-effectiveness of surgical care.

Introduction: A disproportionate number of surgeries in low- and middle-income countries (LMICs) are performed in tertiary facilities. The referral process may be an under-recognized barrier to timely and cost-effective surgical care. This study aimed to assess the quality of referrals for surgery to a tertiary hospital in Ghana and identify ways to improve access to timely care.

Global disease burden of conditions requiring emergency surgery.

Background: Surgical disease is inadequately addressed globally, and emergency conditions requiring surgery contribute substantially to the global disease burden.

Methods: This was a review of studies that contributed to define the population-based health burden of emergency surgical conditions (excluding trauma and obstetrics) and the status of available capacity to address this burden. Further data were retrieved from the Global Burden of Disease Study 2010 and the University of Washington's Institute for Health Metrics and Evaluation online data.

Characterizing the global burden of surgical disease: a method to estimate inguinal hernia epidemiology in Ghana.

Background: Surgical conditions represent an immense yet underrecognized source of disease burden globally. Characterizing the burden of surgical disease has been defined as a priority research agenda in global surgery. Little is known about the epidemiology of inguinal hernia, a common easily treatable surgical condition, in resource-poor settings.

Breast cancer in Kumasi, Ghana.

Background: Breast cancer is the leading cause of cancer deaths in Ghanaian women.

Objective: To describes the characteristics of breast cancer patients attending the Komfo Anokye Teaching Hospital in Kumasi, Ghana.

Method: The study was conducted at the Komfo Anokye Teaching Hospital.

Inguinal hernia disease in Africa: a common but neglected surgical condition.

Background: Hernia surgery is one of the most frequent procedures done by surgeons - paediatric and general surgeons -in the African continent.

Objective: To review the surgical literature, on the epidemiology, clinical features, treatment and outcome of inguinal hernia surgery in Africa.

Data Source: The search terms used were groin hernias in Africa, hernia surgery in Africa, inguinal hernias in Africa, hernias in adults and hernias in children in Africa using Medline, Cochrane Central Register of Controlled Trials and EMBASE.

Penetrating abdominal injuries in adults seen at two teaching hospitals in ghana.

Background: The incidence of penetrating abdominal injuries (PAI) has increased in the West African sub-region.

Objective: To determine the pattern and management outcome of penetrating abdominal injuries (PAI) in the two main teaching hospitals in Ghana.

Study Design: A prospective and retrospective descriptive study.

Aggressive angiomyxoma in African women: a report of two cases.

Background: Aggressive angiomyxoma (AAM) is a rare soft tissue tumour usually of the perineum. There is no report in the surgical literature of a description of AAM in black Africans.

Objective: To report the first description of AAM in black Africa women in the surgical literature and to highlight the value of special immunostains in the complete characterization these rare tumours.

A giant guteal schwannoma with extension into the pelvis: a case report.

Background: Schwannomas are uncommon slow growing tumours arising from the nerve sheath or Schwann cell.

Objective: To report a case and the surgical removal of a giant complex schwannoma and to highlight the value of extensive investigations including a preoperative histologic diagnosis in the successful surgical management of uncommon large benign tumours.

Methods: A 39-year-old man presented with a 15-year history of a large mass in the right gluteal region.